Hello Steemers!!!
Do you have a Dental Insurance? What kind of Dental Insurance do you have? What does your Dental Insurance cover? How satisfied are you with your Dental Plan? Do you feel cheated somehow?
Today we will be going in depth of this Mythical/Hypothetical term Dental Insurance.
What is a Dental Insurance?
It is a type of Health Insurance (but not covered in it) which is (supposed) to finance your dental needs. Dental Insurance have been since 1950. Earlier to it the Insurance companies assumed that Dental Needs violated the basic principle of Insurance - THE RISK and its characteristics. Dental Insurance literally is not a true insurance but a dental Coupon or Dental Benefit Plans.
Dental Insurance can be of any of the following types:
- Commercial Insurance
- Deductible
- Co-insurance
- Group Insurance
- Delta Plans
- Blue Cross Blue Shield Plans
- Capitation Plans
You probably have heard about HMO, PPO, indemnity plans, they belong to the above category.
Without going into the details of them (though all are same), these all are third party plans.
As these are all third party meaning they are private carriers so they solely are based on Profit making in order to grow their business.
What is maximum Limit?
It refers to the maximum amount that a company is willing to reimburse for your dental needs for that year. After the maximum limit is reached patient has to pay out-of-pocket for the rest treatments. This Limit generally is in the range of 1000$ to 1500$. Which has been same from almost 70yr. Looks like it is inflation proof. The average expenditure for a house in US has grown from 17k to 120k per annum. The dental plan limit has since remained at 15k, although The premiums have gone up more than 10 folds.
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Overview of the System
Generally the monthly premiums of different Companies are around 50$ which amounts for about 600$ a year. The General routine Check up, Cleaning and a few x-rays and a filling will cost you around 400 to 500$. Now if your tooth requires a Root Canal and Crown which itself costs around 1000$ to 2000$. Since you have Limit of 1500$ you have to pay the exceeded amount of money out-of-pocket. So you will be paying the exceeded amount plus the daily premium of the plan which was of no avail at the time of need.
What does your Dental insurance Cover?
The Dental insurance is a misnomer for Dental Benefits or Coupons and is a different thing from Medical insurance. True insurance coverage entails for paying premiums in exchange of coverage against some catastrophic losses or expenses. The dental insurance has a maximum amount of reimbursement for dental needs. Generally the Dental plans offers what is known as 100-80-50% Coverage.
That means insurer will pay 100% of the total cost for the basic preventive and diagnostic procedures which include two routine check ups, cleaning, and a few X-rays.
For the Fillings, Root Canal, or Dentures the plan is going to pay only 80% of the cost even if you haven't exhausted your maximum limit. Rest 20% will be paid out-of-pocket.
Whereas for the Crowns and Bridges the Plan is going to pay only 50% of the cost.
The Cosmetic Dentistry, Implants, Most Surgical Procedures, Laser Dentistry or even the Advanved Dental Procedures are not covered by the "Dental Insurance".
About the Orthodontic Treatment of your kids, some companies may reimburse you with some of the expenses but literally after winning a war. However, no orthodontic treatment for adults is covered.
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The Waiting Period?
The waiting period or probationary period is the worst of all. So you are having a cavity, thus want to have a dental plan to get it filled instantaneously. Well that is not gonna happen. The first time you become insured, the company will provide you with reimbursements of basic dental needs only after 3 months, however, Fillings, root canal and crowns will not be entertained till 12 months of time period for policy.
Where does this money go?
If you are willing to hear where your premium dollars are spent? According to the 2016 annual report of Delta, CEO James Dwyer is paid $2,721,170 (an invrease from $700,000 in 2015). $320,874,000 are the total assests of Delta Plan Company. So think about it next time you see your maximum limit of 1500$. This is just an example of Delta plans and the others are no different.
Do you really need a Dental Insurance?
That is the question only you can answer. Although certian factors like age do favour it.
National Association of Insurance Providers claim that only 3% of the total US population reach the Maximum limit. Thus, if 97% spend less than 1500$ every year on dental insurance, why not be your own insurance company and set aside the same money you pay as premiums inorder to be able to pay when the need arises.
Things to Consider
Now that you are absolute sure that you need the Dental plan, still you need to consider some of the things before going for any plan:
- The Premiums being charged.
- The benefits of the plan.
- The maximum limit of the plan.
- The Exclusions of the plan.
- Additional fees.
Are there any Dental Insurance that Covers Everything? Does it Exist?
As in now and foreseeable future there is no such Dental Plan that covers all the Dental Procedures be it Old or New, Surgical or Non-invasive. You have a better chance of finding the unicorn under your bed than finding that Plan.
My thoughts!!!
Dentistry is not expensive, Neglect is. However, there are times when you do require the dental treatments. Be it old age or some developmental disorders. Even if you have a family and need dental plan for them or your employer is providing you with one, do consider the above basic things before handing down your dollars to them.
Also never dictate your dental needs by your dental plan. And as a dentist i have taken an oath not to dictate my treatment plan by dental plan. Always choose what is best and at the same time efficient for you and your family.
With these words i leave you to ponder upon ypur choices untill next time...
Steem On!!!
MAY THE STEEM BE WITH US
HAVE YOU READ MY PREVIOUS POSTS ON
1. Dental Health Education in Community Schools
2. Dental Amalgam and its Health Hazards
